Race and gender differences in abnormal blood glucose screening and clinician response to prediabetes: A mixed-methods assessment.
Prev Med
; 148: 106587, 2021 07.
Article
in En
| MEDLINE
| ID: mdl-33930437
ABSTRACT
The projected three-fold increase in diabetes burden by 2060 in the United States will affect certain race and gender groups disproportionately. The objective of this mixed-methods study was to assess differences in prediabetes screening and clinician response to prediabetes by patient race and gender. We utilized data from 18,742 patients seen between 11/1/15 and 4/30/17 who met criteria for blood glucose screening by the 2015 US Preventive Service Task Force recommendation and had at least one visit to a primary care practice within a large, academic health system located in North Carolina. We utilized generalized estimating equations with logistic regression to assess race and gender differences in two outcomes:
prediabetes screening and clinician response to prediabetes. We conducted twenty in-depth interviews (October 2018-May 2019) with physicians to assess their approach to screening for and treating prediabetes. Black patients had 11% higher odds (95% CI1.02-1.20) of being screened for prediabetes than White patients. Men had 19% higher odds (95% CI1.09-1.30) of being screened for prediabetes than women. There were no significant differences in clinician response to prediabetes by patient race or gender. Qualitatively, physicians reported a non-systematic approach to prediabetes screening and follow-up care related to 1) System-level barriers to screening and treatment; 2) Implicit bias; 3) Patient factors; and 4) Physician preferences for prediabetes treatment. Targeted risk-based screening for prediabetes along with increased treatment for prediabetes are critical for preventing diabetes and reducing diabetes-related disparities.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Prediabetic State
/
Diabetes Mellitus
Type of study:
Diagnostic_studies
/
Guideline
/
Qualitative_research
/
Screening_studies
Limits:
Female
/
Humans
/
Male
Country/Region as subject:
America do norte
Language:
En
Journal:
Prev Med
Year:
2021
Type:
Article